HEALTHPOINT USER GUIDE.

Transcription

1 HEALTHPOINT USER GUIDE.

2 CONTENTS 1. Getting Started with HealthPoint Introduction Everyday Procedures HealthPoint Maintenance 5 2. Contact Details HealthPoint Helpdesk Contacts Merchant Enquiries Health Fund Contacts 7 3. Introducing the HealthPoint terminal The HealthPoint Screen The Idle Screen 9 4. Symbols Some Tips from the Health Funds HealthPoint Admin Menu Map Quick Reference Guide Obtaining a HealthClaim Rebate Estimate Creating a Health Claim against a Health Fund Cancelling a Health Claim Printing a HealthClaims Reconciliation Report Printing a HealthClaims Activity Report Changing the Provider List Changing the Item List Detailed User Guide Obtaining a HealthClaim Rebate Estimate Overview Step by Step Guide Creating a HealthPoint Claim against a Health Fund Overview Step by Step Guide Claim Receipt Example Cancelling a HealthPoint Claim Overview Step by Step Guide Cancellation Receipt Example Reporting Overview HealthClaims Shift Total Report 37

3 8.4.3 HealthClaims Reconciliation Report HealthClaims Activity Reports Printing Reports Step by Step Guide Practice Activity Reconciliation Same Day Reconciliation Next / Future Day Reconciliation Item Maintenance Overview List Maintenance Step by Step Guide Editing Item Details Sub Process Step by Step Guide Practice Maintenance Overview Practice Maintenance Process Practice Maintenance Step by Step Guide Provider Merchant Association Overview Step by Step Guide Reconciliation Guide Claims Settlement Solution (CSS) How to Reconcile your Accounts - Easy as Training Mode Training Mode Overview Activating and Deactivating Training Mode Frequently Asked Questions HealthPoint Claims FAQs HealthPoint Reconciliation FAQs HealthPoint Reporting FAQs HealthPoint Transaction FAQs HealthPoint Cost & Payments FAQs Terminal FAQs Health Fund FAQs HealthPoint Application FAQs HealthPoint Setup FAQs Appendix A: Health Fund Responses Claim Responses Item Responses Cancellation or Rejection (Void) Responses 67

4 4 HealthPoint User Guide

5 HealthPoint User Guide 5 1. GETTING STARTED WITH HEALTHPOINT Welcome to HealthPoint, the complete health payments processing system! This user guide covers HealthClaims functionality, for making ancillary claims against private health funds. Other HealthPoint features supported on this device are EFTPOS, and Medicare Easyclaim. To help you find your way through this guide, you may like to use the following lists of topics. 1.1 Introduction For an introduction to HealthPoint and HealthClaims, read: 1. The HealthPoint keypad (starting on page 8) 2. Some tips from the health funds (page 11) 3. The Quick Reference Section (starting on page 13) 1.2 Everyday Procedures For the details of the everyday procedures covered in HealthPoint training, see the following sections: 1. The Quick Reference Section, starting on page 13, is a useful summary of procedures or daily use 2. Creating a Health Claim and submitting it (starting on page 19) 3. Cancelling a Health Claim (starting on page 35) 4. HealthClaims reporting (starting on page 36) 1.3 HealthPoint Maintenance HealthPoint training also covers the following maintenance procedures: Item Maintenance editing the standard list of items codes etc (starting on page 43) Practice Maintenance updating practice and provider details (starting on page 47)

6 6 HealthPoint User Guide 2. CONTACT DETAILS 2.1 HealthPoint Helpdesk Contacts CSC HealthPoint Website csc.com/healthpoint - the CSC HealthPoint website contains a variety of information including Item Codes, Health Fund by Modality flyers, User Guides CSC HealthPoint Helpdesk For reporting of HealthPoint faults, instructions on how to process HealthPoint transactions and adding or deleting providers call: Available: Monday to Friday, 8.00am to 6.00pm AEST and Saturday 8.00am to 2.00pm AEST (Except for Public Holidays) Note. The training department operates Monday to Friday, 9.00am to 5.00pm AEST (Except for Public Holidays) Please assist us by having your CommBank Merchant number, CommBank Terminal number (found on the HealthClaims receipt) available when contacting the above helpdesks. Your Merchant Details: CommBank Merchant No. CBA ID CBA 2.2 Merchant Enquiries CommBank Merchant Enquiries For general merchant enquires and EFTPOS hardware difficulties call: (24 hours, 7 days a week) Manual Authorisation For Visa/Mastercard Credit Card call: (24 hours, 7 days a week) For Debit Cards call: (24 hours, 7 days a week) Please have the following information ready: merchant number card details - card number, expiry date transaction amount.

7 HealthPoint User Guide Health Fund Contacts For enquiries about a fund member s entitlements or problems with their card, call the relevant fund s Member Services number. For enquiries about provider numbers, or any difficulties with provider payments, call the relevant fund s Provider Information number. Health Fund Member Services Provider Information ACA ahm Australian Unity (03) (03) Budget Direct Health see GMHBA BUPA CBHS cua Health Defence Health Frank Health Insurance see GMHBA GMF GMHBA HBF HCF (02) health.com.au HIF Latrobe Health Services Medibank Navy Health nib Onemedifund Peoplecare (02) Police Health Queensland Country Health (07) RACT Health Insurance see GMHBA rt health Teachers Health TUH (Teachers Union Health) Uni Health Insurance WESTFUND

8 8 HealthPoint User Guide 3. INTRODUCING THE HEALTHPOINT TERMINAL The HealthPoint terminal is an easy-to-use terminal, with just 20 keys. Some of the keys have special functions. Printer built into the Terminal XPOS Button provides access to HealthPoint Menus. Cancel OK / Enter / Yes Clear / No The terminal must be on the base when initiating and submitting a HealthPoint claim.

9 HealthPoint User Guide The HealthPoint Screen Most HealthPoint screens have the following features: Title - Most screens have a unique title. Screen titles highlighted at the top of the screen in black. White Key Labels - If the two outer white keys have a function on the screen, its label appears above the key. For example, Submit a claim, the SUBMIT label appears above the left outer white key 3.2 The Idle Screen Most procedures in this user guide start from the Terminal s Idle screen. For Example: When HealthPoint is displaying this screen, you may swipe a health fund card, Medicare card, and insert or swipe a credit, debit, or charge card. The terminal must be on the base when initiating and submitting a HealthPoint claim.

10 10 HealthPoint User Guide 4. SYMBOLS The following symbols are used in the procedures detailed in this guide. Start Each procedure starts with a description of what state HealthPoint should be in before you work through the procedure. Most procedures start from the Idle screen. Finish The tick indicates you ve completed the procedure. Ω End The Omega symbol indicates that you ve reached an end point in the procedure. You will need to start again. Please Wait This symbol indicates that, at this point in the procedure, HealthPoint makes a telephone call to the CSC Health Message centre to send and receive information. Tip This symbol indicates that there is there is a tip which may be of use.

11 HealthPoint User Guide SOME TIPS FROM THE HEALTH FUNDS To help you avoid some common mistakes with electronic claiming, the health funds have provided the following tips: Every time you swipe a patient s card and submit a HealthClaim, HealthPoint connects to the relevant health fund and makes a real, live claim for your patient. If a patient disputes the amount of a rebate, cancel the claim and advise them to make a manual claim with the health fund. Cancellations must be made on the same day of service. Whenever possible, make one claim for the whole consultation, including all the items covered. Separate claims for each individual item may mean your patient receives a reduced benefit. If a patient is receiving a course of treatment, make claims on a consultation by consultation basis, rather than one large claim at the end of the course. If you are unsure about which service item codes apply for a particular type of service, find them at csc.com/healthpoint or consult your professional association. You must not make a claim for a service or appliance you have not supplied. For example, you cannot claim for a pair of glasses until the patient has actually received the glasses, even if you bill the patient in advance. You must not make claims for deposits taken when ordering appliances (e.g. dental crowns, glasses), then claim for the remainder when the appliance is supplied. Make only one claim for each appliance when the appliance is supplied. Review the HealthPoint Service Terms and Conditions to make sure you understand your legal obligations under your agreement with the health funds. If you need another copy of your terms and conditions, call the CSC HealthPoint Help Desk on Remember that the health funds have the right to refuse to accept a claim that does not comply with their requirements. If in doubt, always consult the health fund in question. The terminal must be on the base when initiating and submitting a HealthPoint claim. The base must have an active internet connection. The terminal can be removed from the base when processing on EFTPOS transaction or gap payment.

12 12 HealthPoint User Guide 6. HEALTHPOINT ADMIN MENU MAP

13 HealthPoint User Guide QUICK REFERENCE GUIDE For more information on any step in the following quick reference procedure, please refer to the Detailed User Guide in Section Obtaining a Rebate Estimate on HealthPoint ÂÂ Start from the Idle screen, with the terminal on the base. 1. Swipe the patient s health fund card. 2. Enter the patient reference number, then press [OK]. 3. HealthPoint displays the PROVIDER OF SERVICE screen, select the servicing provider from the list by pressing the corresponding number key. 4. Add up to 16 service items from the list. a. Find the service item use the arrow keys to navigate to the item b. Press the corresponding number to select the item. c. Press 2 to edit the fee, enter the fee and press [OK] d. Press [OK] to add the selected item to the claim. e. Either select [ADD] to add more items, or press [OK] to complete the claim with the selected items. 5. To submit this Health Claim to the appropriate health fund, select [SUBMIT]. 6. HealthPoint submits the claim and retrieves the health fund response, then prints a claim assessment. 7. Advise the patient of the health fund s rebate of the claim. To end the process, select [REJECT], then [DISCARD]. You have obtained a Rebate Estimate! A Claim has not been processed. To submit a claim after the service is provided, see Section 7.2

14 14 HealthPoint User Guide 7.2 Creating a HealthPoint Claim against a Health Fund ÂÂ Start from the Idle screen, with the terminal on the base. 1. Swipe the patient s health fund card. 2. Enter the patient reference number, then press [OK]. 3. HealthPoint displays the PROVIDER OF SERVICE screen, select the servicing provider from the list by pressing the corresponding number key. 4. Add up to 16 service items from the list. a. Find the service item use the arrow keys to navigate to the item b. Press the corresponding number to select the item. c. Press 2 to edit the fee, enter the fee and press [OK] (See Changing the Item List to pre-populate an amount against specific item numbers). d. Press [OK] to add the selected item to the claim. e. Either select [ADD] to add more items, or press [OK] to complete the claim with the selected items. 5. To submit this Health Claim to the appropriate health fund, select [SUBMIT]. 6. HealthPoint submits the claim and retrieves the health fund response, then prints a claim assessment for the patient to sign. 7. Advise the patient of the health fund s rebate of the claim and ask them if they accept it. a. Option 1: Patient Accepts Rebate Offered. i. To accept the rebate offered, select [ACCEPT]. ii. Have the patient sign the health fund assessment. iii. Verify the patient s signature and write your initials on the assessment. iv. File the patient-signed and verified assessment. Retain for two years. b. Option 2: Patient Rejects Rebate Offered. i. To reject the rebate offered, select [REJECT]. ii. HealthPoint rejects the claim and retrieves the health fund response. The Terminal will show VOID Approved, What would you like to do with the Claim? 1. Select [DISCARD], to discard the claim and return to the swipe screen. 2. Select [MANUAL], to produce a record of the claim for manual processing (go on to step 8). 3. Press [FUNC], then Select [ADJUST], to return to HEALTHFUND summary screen. 8. If you have already received monies from the patient, enter that amount, then press [OK]. If not, leave the amount blank and press [OK].

15 HealthPoint User Guide If there are monies owing, HealthPoint asks for the METHOD OF PAYMENT. Answer the question selecting [EFTPOS], [CASH] or press [FUNC], then select [INVOICE] and process accordingly. 10. If the receipt printed successfully, select [YES, DONE]. a. Give the receipt to the patient. b. HealthPoint returns to the idle screen. You have finished creating a HealthPoint Claim! 7.3 Cancelling a HealthPoint Claim ÂÂ Start from the Idle screen, with the terminal on the base. 1. Select [XPOS]. 2. Press 1 for HealthPoint. 3. Press 2 to Cancel a Claim. 4. Find the Claim to be Cancelled. a. Option 1: Use Claim Receipt Number. i. Enter the claim receipt number, which you can find on the top of the printed claim receipt, then press [OK]. ii. If you have entered the Claim ID, the Claim will be retrieved and presented on screen. Proceed to Step 5. b. Option 2: Swipe the Health fund card used to generate the claim. i. If you have swiped the customer Health Fund Card you will be presented with a list of possible claims to Cancel. ii. To navigate through the possible claims use the arrow keys. 5. Once you have the Claim you want to cancel, Select PROCEED to Cancel the Claim. a. If you have not already done so, you will be prompted to Swipe the patient s card to authorise the cancellation. b. HealthPoint cancels the claim, retrieves the health fund s response, and prints a cancelled receipt. i. Have the patient sign the cancellation receipt. ii. Verify the patient s signature and write your initials on the cancellation receipt. iii. File the patient-signed and verified cancellation receipt. Retain for two years. iv. HealthPoint displays the Print confirmation screen. After the receipt prints correctly, Select [YES, DONE]. 6. HealthPoint prints another copy of the receipt for the patient. a. If this copy has printed correctly, select [YES, DONE]. 7. Select [OK] to finish the cancellation and return to the Idle screen You have finished cancelling a HealthPoint Claim!

16 16 HealthPoint User Guide 7.4 Printing a HealthClaims Reconciliation Report ÂÂ Start from the Idle screen, with the terminal on the base. 1. Select [XPOS]. 2. Press 1 for HEALTHPOINT. 3. Press 9 for HEALTHPOINT ADMIN. 4. Press 2 for REPORTS. 5. Press 2 for RECONCILIATION. 6. Enter the Date for reconciliation, then Press [OK]. This should be entered as DDMMYYYY. 7. HealthPoint prints the reconciliation report. 8. Once printed, Select [YES, DONE] to return to the HealthPoint Admin Menu You have successfully retrieved and printed your report. 7.5 Printing a HealthClaims Activity Report ÂÂ Start from the Idle screen, with the terminal on the base. 1. Select [XPOS]. 2. Press 1 for HEALTHPOINT. 3. Press 9 for HEALTHPOINT ADMIN. 4. Press 2 for REPORTS. 5. Press 1 for ACTIVITY REPORT. 6. Enter the Activity Date, then Press [OK]. This should be entered as DDMMYYYY 7. HealthPoint prints the reconciliation report. 8. Once printed, Select [YES, DONE] to return to the HealthPoint Admin Menu You have successfully retrieved and printed your reports.

17 HealthPoint User Guide Changing the Provider List To update your HealthPoint Provider list you must call the CSC HealthClaim Help Desk on Additional Providers require registration with CSC and the Health Funds prior to claiming on the HealthPoint Terminal. The Provider application can be found on the CSC website. Once the Providers are registered you can update your terminal to reflect the additional Provider. ÂÂ Start from the Idle screen, with the terminal on the base. 1. Select [XPOS]. HealthPoint displays the XPOS menu. 2. Press 1 for HEALTHPOINT. HealthPoint displays the HEALTHPOINT screen. 3. Press 9 for HEALTHPOINT ADMIN. HealthPoint displays the HEALTHPOINT ADMIN screen. 4. Press 3 for UPDATE CONFIG. HealthPoint will display the UPDATE CONFIG screen. a. Choose the Details to be Updated: i. Press 1 to UPDATE ALL details ii. Press 2 to update PRACTICE DETAILS iii. Press 3 to update HEALTH FUNDS details iv. Press 4 to update PROVIDER DETAILS. v. Press 5 to update SERVICE ITEMS b. HealthPoint will print out any applied changes. If there are no updates, HealthPoint will print No New Updates on the print out. 5. HealthPoint will prompt you to confirm that the updates are correct. Select [YES, DONE] You have successfully updated the Providers on your HealthPoint Terminal 7.7 Changing the Item List ÂÂ Start from the Idle screen, with the terminal on the base. 1. Press [XPOS]. 2. Press 1 for HEALTHPOINT. 3. Press 9 for HEALTHPOINT ADMIN. 4. Press 1 for SERVICE ITEMS. 5. Select the SERVICE TYPE you want to modify by pressing the corresponding number key. Note: The terminal will show the Modalities configured on your terminal.

18 18 HealthPoint User Guide 6. Perform one or more of the following items a. To add an item, Select [FIND], enter the new item code then press [OK], then select [YES], edit the item details (1. name and 2. fee), press [OK]. b. To edit an item already on the list, select item, select [EDIT], enter the details, press [OK]. c. To delete an item, select item, press [FUNC] then select [DELETE], and then press [OK]. 7. Confirm the changes made by pressing [OK]. 8. HealthPoint displays the SERVICE ITEMS SUCCESSFULLY UPDATED screen. To return to the HEALTHPOINT ADMIN screen, Press [OK]. You have successfully changed your item list.

19 HealthPoint User Guide DETAILED USER GUIDE 8.1 Obtaining a Rebate Estimate on HealthPoint Overview Use this procedure to obtain a HealthClaim Rebate Estimate for your patient. Note: The patient must have a valid health fund card and be present at the time of transaction For a brief summary of this procedure, see Quick Reference Section Obtaining a Rebate Estimate on HealthPoint Step by Step Guide Follow Step A up to Step G in Section for Creating a HealthPoint Claim against a Health Fund. Once you have advised the patient of the Rebate Estimate, select [REJECT], then [DISCARD] to finish the process. You have obtained a Rebate Estimate! A Claim has not been processed. To submit a claim after the service is provided, follow all the steps in Section Creating a HealthPoint Claim against a Health Fund Overview Use this procedure to create a Health Claim and submit it to a fund, on behalf of your patient. On conclusion, a HealthClaims Receipt is printed for both your practice records and your patient. The HealthClaims Receipt is a paper record of the claim sent to the health fund via HealthPoint. Note: The patient must have a valid health fund card and be present at the time of claim For a brief summary of this procedure, see Quick Reference Guide Creating a HealthPoint Claim against a Health Fund.

20 20 HealthPoint User Guide Step by Step Guide Start from the Idle screen, with the terminal on the base. A Step A Swipe the patient s health fund card. Step A.1 If the swipe is successful, and HealthPoint displays the PATIENT REF NO Screen proceed to Step B. B Step A.2 If the card won t swipe, you cannot proceed with the claim. Please inform your patient that you are unable to process a Health Claim on their behalf as their card is not registering. END Ω Step B Enter the patient reference number (on their health fund card, to the left of their name), then press [OK]. Note: You do not have to enter a leading zero. For example, if the patient is numbered 01 on the card, just enter 1 into HealthPoint. If the patient reference number is not shown on the card (e.g. on some older Medibank Private cards), derive it from the patient s position in the list of patients on the card. Start with patient 1 at the top of the list. Count down the first column and then down the second column, until you reach the patient you are referring to. Step B.1 If this is the first patient, go to Step C Step B.2 If this is a subsequent patient, go to Step D C Step C Select the servicing provider. Step C.1 HealthPoint displays the PROVIDER OF SERVICE screen. Step C.2 Select the servicing provider from the list by pressing the corresponding number key a) If the provider is not on the first screen, see more screens of providers, by pressing the white arrow keys. b) If the provider is not available on the terminal you will need to update your practice details. See Section Practice Maintenance. END Ω

21 HealthPoint User Guide 21 Step C.3 HealthPoint displays a list of services applicable to the provider selected. For example, if you selected a provider who is Dentist, the services displayed might look like this: D Step D Add up to 16 service items to the health claim Step D.1 Find a Service Item D1.a Option 1: Navigate through the list using the white arrow keys to find the service item. When the item is displayed on the screen press the corresponding number key to select it. Go to Step D.2 D1.b Option 2: Search for the item, by selecting [FIND] 1. HealthPoint displays the KEY SERVICE screen 2. Enter the Item Code and Press [OK] 3. If the item is not found, go to Step D.4) 4. If the item is found, HealthPoint displays the selected ITEM SUMMARY Screen. Choose an option: i. To add the service item as is, Go to Step D.2) ii. To adjust the service item, Go to Step D.6) Adjust Service Items Step D.2 Add Service Item D2.a Press [OK] to add the item to the claim. D2.b HealthPoint displays the SELECTION PATIENT * screen. This screen shows the items you have added to the claim for the current patient.

22 22 HealthPoint User Guide Step D.3 Add / Edit items for the current patient a) If nothing further is required Press [OK] to make the claim, Go to Step E b) If items need to be added / edited Choose the relevant option below i. To add another item - Select [ADD]. Go to Step D.1 ii. To edit an item, navigate to the item using the arrow keys and select the number key corresponding to the item. Go to Step D.6 iii. To remove an item from your list, Go to Step D.7 iiii. To check your current list of items, navigate up and down using the arrow keys. When finished, return to Step D.3 Step D.4 If the Item is not found in your list, HealthPoint displays the ITEM NOT FOUND screen a) To add an ad-hoc item to this claim, but not your regular list of items Select [ADHOC] - Go to Step D.5 b) To add an item both to this claim and your regular list of items, Press [FUNC], then Select [YES] Go to Step D.5 All changes made to this item will be saved in your standard list. c) To return to the KEY SERVICE screen (without adding the item), Select [NO] Return to D1.b1 Step D.5 Add New Service Item to Claim a) To add the item as is, Press [OK] b) To make a copy of current item, Select [COPY X 1 ]. i. HealthPoint copies the item, as displayed on the screen, to your claim. ii. HealthPoint then displays the copy of the item on the screen as a new current item. HealthPoint displays the number of copies made next to the COPY key. iii. You can now make changes to this new copy of the item. To edit the item, Go to Step D.6 1 Where X is the number on the screen

23 HealthPoint User Guide 23 The Copy function is particularly useful if the only changes made to the item are to enter a different body part or tooth number. c) To discard the item, select [DISCARD]. HealthPoint returns to the KEY SERVICE screen. If required, keep pressing the [CLEAR] button until you return to the SELECTION PATIENT Screen. Return to Step D.3 Step D.6 Adjust Service Items a) Choose the relevant option below: i. To Adjust the Date of Service Go to D6.b ii. To Adjust the Fee for the Service Go to D6.c iii. To Adjust the Description for the Service Go to D6.d iv. To Adjust the Tooth Number for the Service Go to D6.e v. To Adjust the Body Part for the Service Go to D6.f b) Option 1: To adjust the date of service, press the number key next to DATE. i. HealthPoint displays the SERVICE DATE screen. ii. Select the date of service from the list by pressing a number key. 1. Press 1 for Today 2. Press 2 for Yesterday 3. Press 3 for another day, then enter the date as one big number in the format DDMMYYYY (day month year, with no spaces in between), then press [OK]. iii. To continue adjusting the item, Return to D6.a, else go to D6.g Note: A claim cannot be made for a service to be delivered at a future date.

24 24 HealthPoint User Guide c) Option 2: To adjust the fee for this service, press the number key next to FEE. i. HealthPoint displays the SERVICE FEE screen. ii. HealthPoint displays the fee stored in the item list. Enter the correct fee by typing over the fee displayed, and then press [OK]. iii. To continue adjusting the item, Go to D6.a, else go to D6.g Note: The fee entered must always be equal to the amount actually charged to the patient including discounted amounts. Adjusting the fee will only modify the fee for the current transaction. d Option 3: To adjust the description, press the number key next to DESCRIPTION i. HealthPoint displays the SERVICE DESCRIPTION screen ii. Enter the Item s name and then press [OK] Press the key labelled with the letter one or more times, according to the letter s position. For example, the 2 key is labelled ABC. To enter A, press 2 once, to enter B, press 2 twice, and to enter C, press 2 three times. iii. To continue adjusting the item, Go to D6.a, else Go to D6.g e) Option 4: To adjust the tooth number (dentists only), press the number key next to TOOTH NUMBER. i. HealthPoint displays the TOOTH NUMBER screen. ii. Enter the two digit ADA (Australian Dental Association) standard tooth number, and then press [OK]. iii. To continue adjusting the item, Go to D6.a, else Go to D6.g The only exception is if you are modifying an item after choosing to add it to the standard list. Refer to D4.b

25 HealthPoint User Guide 25 f) Option 5: To adjust the body part (Physiotherapists only), press the number key next to BODY PART i. HealthPoint displays the BODY PART screen. ii. Enter the body part for this item, and then press [OK]. iii. To continue adjusting the item, Go to D6.a, else Go to D6.g g) Add Adjusted Item? E i. Choose an Option below: 1. Option 1: To add the updated item to your claim, press [ENTER] 2. Option 2: To discard the changes made, press [DISCARD] ii. HealthPoint returns to the item list screen for the current patient Go to Step D.3 Step D.7 Remove Service Item from Claim a) Find the Service item you want to remove by using the arrow keys b) Press the number next to the Service Item. HealthPoint displays the Item Summary screen c) Select [DISCARD] d) The Item is removed from the screen. HealthPoint returns to the item list screen for the current patient Go to Step D.3 Step E Review Claim Step E.1 To make the claim with the items displayed, go to Step F. Step E.2 To see a summary of the claim, use the arrow keys to navigate up and down. Return to the top of the screens to make your claim. Go to Step F F Step E.1 To add another patient, select [ADD]. Return to Step B Step F Submit your Claim Step F.1 To submit this HealthClaim to the appropriate health fund, select [SUBMIT]

26 26 HealthPoint User Guide Step F.2 HealthPoint attempts to make a connection to the HealthPoint systems, and displays a message on the screen, which indicates what it is currently doing. These messages include: CONNECTING TO HOST SENDING PLEASE WAIT RECEIVING PLEASE WAIT PRINTING PLEASE WAIT a) OUTCOME 1: Claim is successful i. If the Claim submission is successful, the HealthPoint terminal prints a copy of the claim receipt (including the assessment) and displays the HEALTH FUND assessment screen. Go to Step G The printed assessment shows the health fund s responses to each item and to the claim as a whole. A response of 00 or 0000 means the claim or item has been approved. Explanations of the other responses are detailed in Appendix A: Health Fund Responses (see page 67). b) OUTCOME 2: Health Fund rejects the claim i.if the Health Fund has rejected the claim, see Health Fund Responses to HealthClaims for information on what to do next. END Ω c) OUTCOME 3: Error occurs during transmission If an error occurs during the claim submission, HealthPoint displays the relevant error screen. Most errors that occur during a claim submission are one-offs. We recommend you try again (press [RETRY]). c2) Choose the appropriate option below: c2 (1) To resubmit the claim: i. Select [RETRY], HealthPoint tries to send the claim again. ii. If the error occurs again, call the CSC HealthPoint Help Desk on END Ω

27 HealthPoint User Guide 27 G c2 (2) c2 (3) To discard the claim completely: i. Select [DISCARD] ii. HealthPoint discards the claim completely, and then returns to the Idle screen. You will need to restart the claims process from 1. To process a manual claim: i. Select [MANUAL] ii. HealthPoint will stop processing the health claim, and the patient will need to make a manual claim with their Health Fund to secure their rebate. Go to 8 Step G Advise the patient on the health fund s rebate of the claim and ask them if they accept it. Note: If you press [FUNC] and select [PRINT], HealthPoint prints another copy of the receipt. Step G.1 If the patient accepts it: a) Have the patient sign the health fund assessment. b) Verify the patient s signature and write your initials on the assessment. c) File the patient-signed and verified assessment. Retain for two years. d) Select [ACCEPT], Go to 8. Step G.2 If the patient rejects it: a) Select [REJECT] b) HealthPoint attempts to make a connection to the HealthPoint systems to send a claim rejection (similar process to the claim submission) i. If successful, go to G2.c ii. If an error occurs during the claim submission, HealthPoint displays the HEALTH FUND failed submission screen, and will ask you if you want to print a manual receipt. Error messages include: Fund Busy Fund Unavailable System Problem B Link Down RDX Disconnect b2 (1) Answer the question Do you wish to print a manual receipt? : i. Select [DISCARD], HealthPoint discards the rejection, and then returns to the Idle screen. END Ω

28 28 HealthPoint User Guide As the claim submission process was not completed, there is no record of the claim. The entire transaction is cleared from the terminal. You may like to try again in a few minutes to see if the Health Fund becomes available. ii.if you press [RETRY], HealthPoint tries to REJECT the claim again. If this is unsuccessful, contact the Health Fund to confirm or log a request for the HealthPoint team to investigate. c) After HealthPoint has finished rejecting the claim and receiving the health fund s response, it prints a copy of the rejection receipt. c.1) If the health fund does not accept the rejection, see Health Fund Responses to HealthClaims for information on what to do next. END Ω c.2) If the health fund accepts the claim rejection, HealthPoint displays the VOID APPROVED screen. H For example: G2.c2 (1) Answer the question on the VOID APPROVED screen i) To discard your claim - Select [DISCARD], HealthPoint returns to the Idle screen. You have discarded the claim you were submitting. END Ω ii) To make a manual claim - Select [MANUAL], the patient should make a manual claim with their Health Fund. Go to Step H iii) To adjust your claim Press [FUNC], then select [ADJUST], HealthPoint returns to the HEALTH FUND summary screen. Navigate to the items you wish to adjust and submit it again. Return to Step F Submit your Claim Step H HealthPoint displays the ENTER DEPOSITS RECEIVED screen. H.1 If you have already received monies from the patient, perhaps by way of a deposit or down payment, enter that amount, and then press [OK].

29 HealthPoint User Guide 29 H.2 If there was no deposit paid, leave the amount as zero and press [OK]. I H.3 HealthPoint adjusts the gap amount by the amount you just entered. Step I Monies Owing Step I.1 Option 1: If there are monies owing to the Service Provider (because the rebate did not cover the fees for the services rendered), HealthPoint displays the METHOD OF PAYMENT screen. Select the payment method: I1.a1 To allow the patient to pay by EFTPOS, select [EFTPOS], and process the EFTPOS transaction according to the Quick IWL255 Merchant Operator Guide. If your terminal is Multi Merchant, you will be required to select the Merchant for payment. Go to Step J I1.a2 To allow the patient to pay by cash, select [CASH]. Go to Step J I1.a3 To allow the patient to pay by invoice, Press [FUNC], then select [INVOICE], HealthPoint will print accounts. Go to Step J The receipt prints out the remaining gap. The practice will need to decide how they wish to process this remaining gap. Step I.2 Option 2: If there are monies owing to the Patient (For example, if the patient has overpaid), HealthPoint displays the METHOD OF PAYMENT screen. J I2.a Select the payment method: I2.a1 To refund the patient to via EFTPOS, select [EFTPOS], and process the EFTPOS transaction according to the Quick IWL255 Merchant Operator Guide. If your terminal is Multi Merchant, you will be required to select the Merchant for payment. Go to Step J I2.a2 To refund cash to the patient, select [CASH]. Go to Step J Step J HealthPoint will print the relevant receipts, then ask if the receipt is printed correctly.

30 30 HealthPoint User Guide Step J.1 If the receipt is correct, select [YES, DONE] Give the receipt to the patient. HealthPoint returns to the Idle screen. You have finished creating a HealthPoint claim! Step J.2 If the receipt did not print correctly, select [NO, REPRINT]. Return to Step J Step J.3 If the receipt did not print correctly, and it is not required, Press [FUNC] then Select [NO, SKIP]. HealthPoint returns to the Idle screen. You have finished creating a HealthPoint Claim!

31 HealthPoint User Guide Claim Receipt Example Your CBA ID and Claim Reference Number Name of Health Fund Claim Response Gap Fees charged, Rebate the fund will pay, Item Response Code Description of each response code is printed on the receipt Patient Signs here Write your initials here

32 32 HealthPoint User Guide 8.3 Cancelling a HealthPoint Claim Overview HealthPoint allows you to cancel a HealthPoint claim on the same day that it was submitted. A Health Claim can only be cancelled if: The Patient is at your practice, and you have their Health Fund card The Claim was submitted earlier in the day (note: the day ends at midnight and is based on Sydney, Australia time) The HealthClaims service is available (note: this varies based on the Health Fund s agreed operating hours) Once you have printed a reconciliation report for a day, you can no longer cancel claims on that report through HealthPoint. For a brief summary of this procedure, please refer to the Quick Reference Section Cancelling a HealthPoint Claim Step by Step Guide Start from the Idle screen, with the terminal on the base. A B C Step A Select [XPOS].HealthPoint displays the XPOS menu Step B Press 1 for HealthPoint Step C Press 2 for Cancel Claim Step C.1 If required, enter your four digit operator ID, then press [OK]. B Step D Find the claim to cancel Step D.1 HealthPoint will display the Find Claim screen. To find a specific claim, you have two options.

33 HealthPoint User Guide 33 Step D.2 Option 1: Find using the claim receipt number a) Enter the claim receipt number, which you can find on the top of the printed copy of the claim, and press [OK]. b) HealthPoint retrieves the claim and displays it on the terminal. Go to Step E. Key in this Note: You only need the second part of the number after the space. Note: You do not need to key in all of the zeros at the front of the claim number. For example, to find claim , you only need to key in 20. E Step D.3 Option 2: Find a claim associated with a membership a) To find a claim associated with a membership, Swipe the Health Fund Card used to submit the claim. b) HealthPoint will connect to the HealthPoint Claim server and find all the claims associated with the membership card that were submitted on the current day. c) If more than one claim was submitted, Press [FUNC] and Select [NEXT] to navigate to through the claims, until the appropriate claim is reached. Go to Step E. Step E To cancel this HealthClaim with the appropriate health fund, Select [PROCEED]. Note: If the patient is no longer at your practice and you do not have their card, you CANNOT cancel the claim. The health funds only permit cancellation if you use the health fund s card in the presence of the patient on the same day that the claim was submitted. Step E.1 If you have already swiped the patient s card to find the claim, Go to Step F.

34 34 HealthPoint User Guide Step E.2 If you have found the claim by entering the Claim ID, HealthPoint displays the CANCEL FUND CLAIM screen. a) Swipe the patient s card. b) HealthPoint attempts to make a connection to the HealthPoint systems. c) If successful, go to Step F. d) If an error occurs during the claim submission, HealthPoint displays the HEALTH FUND failed submission screen. For example: d1) Answer the question by pressing the blue FUNCTION key for the slide out menu. d2) If you select [RETRY], HealthPoint tries again to cancel the claim. d3) If you select [DISCARD], HealthPoint discards the attempt to cancel the claim, and then returns to REVIEW CLAIM screen. F Step F HealthPoint processes the cancellation and prints a copy of the Cancellation receipt. The receipt shows the health fund s responses to the cancellation. A response of 00 means the cancellation has been accepted and approved. Note: Explanations of the other responses are detailed in the Cancellation and Rejection Responses section of Appendix A: Health Fund Responses. Step F.1 HealthPoint displays the PRINT CONFIRMATION screen Step F.2 If it has printed incorrectly, select [NO, REPRINT] Step F.3 Else, select [YES, DONE] another copy of the receipt will print

35 HealthPoint User Guide 35 G Step G HealthPoint displays the PRINT CONFIRMATION screen Step G.1 If it has printed incorrectly, select [NO, REPRINT] Step G.2 Else, Select [YES, DONE]. HealthPoint displays the Claim Cancelled screen. Step G.3 Press [OK] to return to the Idle screen. H Step H Sign Receipts Step H.1 Have the patient sign the cancellation receipt. Step H.2 Verify the patient s signature and write your initials on the cancellation receipt. Step H.3 File the patient-signed and verified cancellation receipt. Retain for two years. You have finished cancelling a HealthPoint claim!

36 36 HealthPoint User Guide Cancellation Receipt Example Name of Health Fund Items being Cancelled Description of each response code is printed on the receipt Patient Signs here Write your initials here

37 HealthPoint User Guide Reporting Overview HealthPoint provides three types of reports in order to aid you with reconciliation at your practice. The available reports are: HealthClaims Shift Total Report HealthClaims Reconciliation Report HealthClaims Activity Report For more information, see the corresponding sections below: Please note if there are no reports available for a particular day a message will appear as follows: FAILED TO RECEIVE XX DUE TO NO REPORT FOR DATE HealthClaims Shift Total Report The HealthClaims Shift Total Report, allows you to break up your reporting throughout the day to allow for running totals. The Shift Total Report can be printed on the claim date to allow for reconciliation on the same day as claim submission. The HealthClaims Shift Total report is HealthPoint s record of the claims sent through to each health fund during a shift. By executing the report: All the transactions from the shift are printed A new shift is started A Shift starts from the beginning of the day, until the first Shift Total Report is printed. Subsequent shifts are from the end of the previous shift, to the next Shift Report Multiple shift reports can be printed during the day. However, each claim will only appear on one Shift Total report. If you print more than one Shift Report for a day, be sure to add the totals when reconciling with the Reconciliation and/or the Activity report.

38 38 HealthPoint User Guide Shift Total Report Time span of shift on the report Each health fund is listed for each provider One line for each claim. One line for each void or cancellation Total for this fund, for this provider, for this shift Total for all claims for this provider, for this shift These totals should reconcile with the activity report for the day

39 HealthPoint User Guide HealthClaims Reconciliation Report The HealthClaims Reconciliation report is HealthPoint s record of the claims sent through to each health fund during a particular day. Each provider is shown in a separate section. The Reconciliation report can be printed once for any given day, and is available to be printed the following day. Once you have printed today s reconciliation report, you can no longer cancel claims on that report through HealthPoint. CSC recommends that you print this report at close of business. Reconciliation Report Date selected for the report Each health fund is listed for each provider One line for each claim. One line for each void or cancellation Total for this fund, for this provider, for this day Total for all claims for this provider, for this day These reconciliation totals should match those shown on the activity report for this day

40 40 HealthPoint User Guide HealthClaims Activity Reports The HealthClaims Activity Report shows totals for the claims, voids (rejections), and cancellations made during a particular day. The report is created by the CSC HealthPoint systems at the end of each working day and will be available for you to retrieve on the next working day. You may retrieve reports at any time. If there are no reports waiting for you to retrieve, there is no harm done. If you printed more than one SHIFT TOTAL report during a day (e.g. because you had a change in staff), add the totals of all the SHIFT reports before reconciling with the activity report. There is only ever one activity report per day. HealthPoint Activity Report Date the claims included in the totals were processed and submitted These transaction totals should match those shown on the reconciliation report(s) for this day

41 HealthPoint User Guide Printing Reports Step by Step Guide Start from the Idle screen, with the terminal on the base. A Step A Press [XPOS]. HealthPoint displays the XPOS menu. B C Step B Press 1 for HEALTHPOINT. HealthPoint displays the HEALTHPOINT screen. Step C Press 9 for HEALTHPOINT ADMIN. HealthPoint displays the HEALTHPOINT ADMIN screen. D Step D Press 2 for reports. HealthPoint displays the reports screen. E Step E Choose the Report you want to Print. a) Press 1 for ACTIVITY REPORT. Go to Step F b) Press 2 for RECONCILIATION. Go to Step G c) Press 3 for SHIFT Reports. Go to Step H

42 42 HealthPoint User Guide F G Step F Choose date for Activity Report a) HealthPoint will prompt you for the ACTIVITY DATE for the report. b) Enter the date as one big number in the format DDMMYYYY (day month year, with no spaces in between), then press [OK]. c) HealthPoint retrieves and prints the report, then displays the PRINT CONFIRMATION screen. Step G Choose date for Reconciliation Report a) HEALTHPOINT will prompt you for the Reconciliation date. b) Enter the date as one big number in the format DDMMYYYY (day month year, with no spaces in between), then press [OK]. c) HealthPoint retrieves, and prints the report, then displays the PRINT CONFIRMATION screen. H I Step H HealthPoint retrieves and prints the report. HealthPoint will print all the activities from the beginning of the day, or all activities since the last Shift Report was printed. Step I The PRINT CONFIRMATION screen is displayed, with the question Did the Receipt print correctly? a) If a reprint is required, Select [NO, REPRINT]. Return to Step I b) If the Print was not successful, but a reprint is not required, Press [FUNC], then select [NO, SKIP] c) If the Print was successful, Select [YES, DONE] You have successfully printed the HealthClaims Report.

43 HealthPoint User Guide Practice Activity Reconciliation This section describes how a practice can reconcile the health fund transactions that were executed on a given day with the activity they have undertaken. For reconciliation with banking statements, please see Section 9 - Reconciliation Guide Same Day Reconciliation The purpose of same day reconciliation is to allow a practice to balance their books, and check which transactions were approved, rejected or voided over the course of the day. In order to execute Same Day reconciliation on HealthPoint, the Shift Total report will need to be used (See 8.4.5). One Shift per Day If your practice does not use the Shift Total report during the course of the working day, print a Shift Total report at the end of the day, to use for your reconciliation purposes. Multiple Shifts per Day If your practice prints Shift Total reports during the course of the working day, these will need to be kept aside until you reconcile at the end of the day. When it is time for you to reconcile, print a Shift Total report. Take this report along with the other Shift Total reports that were printed during the day, in order to reconcile the day s activities Next / Future Day Reconciliation The Reconciliation Report and Activity Report are generated at the end of each day and are stored on HealthPoint systems. These allow a practice to reconcile with banking statements and previous day s activities. Next Day Reconciliation If your practice reconciles a previous day s activities, the day after, then you can use both the Activity and Reconciliation report. Print a copy of the Activity and Reconciliation Reports entering the previous day s date as the report date (See 8.4.5). These reports can be reconciled with your previous day s activities. If you printed out Shift Reports for Same Day Reconciliation, the total of these Shift Reports should match both the Activity and Reconciliation reports. Reconciliation at a future date If your practice reconciles activities at a point in the future, then you can use both the Activity and Reconciliation report. Print a copy of the Activity and / or Reconciliation report, entering the date of the day you wish to reconcile. To reconcile with your CSS Statement, see Section 9 - Reconciliation Guide.

44 44 HealthPoint User Guide 8.6 Item Maintenance Overview This procedure describes how you can maintain the list of items stored on your HealthPoint terminal. You will be able to add, edit and delete items in your list. This includes adding new services or adjusting the fees on existing items. Optometrists: This procedure can be used to edit your ancillary item codes. To edit your MBS item codes for Medicare claiming please refer to the MediClear Quick Reference Guide List Maintenance Step by Step Guide Start from the Idle screen, with the terminal on the base. A Step A Select [XPOS]. HealthPoint displays the XPOS menu. B C Step B Press 1 for HEALTHPOINT. HealthPoint displays the HEALTHPOINT screen. Step C Press 9 for HEALTHPOINT ADMIN. HealthPoint displays the HEALTHPOINT ADMIN screen. D Step D Press 1 for SERVICE ITEMS. HealthPoint displays the SERVICE TYPE screen. This list of service types will depend on the service types (modalities) you have activated on your terminal. For example:

45 HealthPoint User Guide 45 E Step E Select the service type a) Select the service type you want to modify by pressing a number key. b) HealthPoint will retrieve a list of items known to the terminal. For Example: F Step F Perform one (or more) of the following actions: ACTION 1: View more items a) Option 1: Use the arrow keys to navigate in the desired direction b) Option 2: Press [FUNC], then Select [DOWN] ACTION 2: Edit an Item a) Navigate to the item using the arrow keys b) Select the item by pressing the corresponding number key. Item is displayed on screen. c) Edit the item details, as described in Section Editing Item Details Sub Process Step by Step Guide. ACTION 3: To add a new item: a) Press [FIND]. HealthPoint displays the FIND ITEM screen. b) Enter the item code, and then press [OK]. c) Select the appropriate outcome below: c1) Outcome 1: Item is Not Found i. If the new item is not on the list, HealthPoint displays the ITEM NOT FOUND screen. ii. To add the item, Press [FUNC] then Select [YES]. HealthPoint displays the EDIT SERVICE screen. iii. Edit the item details, as described in Section Editing Item Details Sub Process Step by Step Guide.